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2019冠状病毒病所致严重急性呼吸窘迫综合征病情改善后出现的两例成人多系统炎症综合征。

Two cases of multisystem inflammatory syndrome in adults after improvement in severe acute respiratory distress syndrome due to coronavirus disease 2019.

作者信息

Nonaka Tatsuki, Bunya Naofumi, Nakayama Ryuichi, Hagiwara Shunya, Uemura Shuji, Harada Keisuke, Narimatsu Eichi

机构信息

Department of Emergency Medicine Sapporo Medical University Sapporo Japan.

出版信息

Acute Med Surg. 2022 Feb 16;9(1):e737. doi: 10.1002/ams2.737. eCollection 2022 Jan-Dec.

Abstract

BACKGROUND

Multisystem inflammatory syndrome in adults (MIS-A) is a postacute coronavirus disease 2019 (COVID-19) syndrome occurring weeks after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Although this hyperinflammatory syndrome causes significant morbidity, mortality is low. Reports of MIS-A following acute respiratory distress syndrome (ARDS) due to SARS-CoV-2 infection have rarely been reported. We describe two cases of MIS-A that developed after recovery from critical acute COVID-19.

CASE PRESENTATION

We present two cases of MIS-A. In both cases, approximately 4 weeks after the onset of COVID-19, the patients developed gastrointestinal disorders, complicated by other organ damage, and died.

CONCLUSION

ARDS and MIS-A can occur in a patient with COVID-19 at different times of onset. Clinicians should consider MIS-A when unexplained multisystemic abnormalities are noted after the treatment of ARDS due to COVID-19.

摘要

背景

成人多系统炎症综合征(MIS-A)是一种在严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染数周后出现的新型冠状病毒肺炎(COVID-19)后急性综合征。尽管这种高炎症综合征会导致显著的发病率,但死亡率较低。SARS-CoV-2感染导致急性呼吸窘迫综合征(ARDS)后发生MIS-A的报道很少。我们描述了两例在严重急性COVID-19康复后发生的MIS-A病例。

病例报告

我们报告两例MIS-A病例。在这两例病例中,COVID-19发病约4周后,患者出现胃肠道疾病,并伴有其他器官损害,最终死亡。

结论

ARDS和MIS-A可在COVID-19患者的不同发病时间出现。当COVID-19导致的ARDS治疗后出现无法解释的多系统异常时,临床医生应考虑MIS-A。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/615e/8849101/e953e3c31107/AMS2-9-e737-g002.jpg

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